Remarkable vet stories: ‘Find the foreign body, or don’t wake him up’

  • Phil Cramp — a partner at Hambleton Equine Clinic, Yorkshire — recalls one of his most memorable cases of equine surgery, with an eventer that had run into a fence

    “A case that will always stick in my mind is that of an eventer who had run through a fence and staked himself with the fence post,”  says vet Phil Cramp. “It had gone in through the side of his neck and created a large, deep wound. He had the post removed and the wound cleaned, flushed out and stitched.

    “At first, all seemed fine, but the area started to periodically swell up, develop an abscess and he would be in a lot of pain with a stiff neck. There had to be a fragment of the fence left in there somewhere, but despite multiple scans and X-rays, no one could get to the bottom of it.

    “Having had the wound reopened a number of times, he came to me on his very last chance — he was to be put down if I couldn’t solve the mystery.

    “I could clearly find and follow the pocket but I could find no remnants of the fence post or any other foreign body in the wound. So, while he was under general anaesthetic — his third — I decided to use a coat hanger to create a sterilised long probe to extend all the way in. I realised the tract extended a lot further than I thought — about 40cm beneath the shoulder blade — so I enlarged the hole with my fingertips in order to put my whole arm in.

    “I was faced with a choice — keep pushing my hand further into the horse to try to find the foreign body and get it out, or don’t wake him up. It would be dangerous — it was very risky making such a large incision so close to the shoulder joint, and I was very concerned about the nerves and vessels in the area and the damage I could do getting the foreign body out. But I had nothing to lose by trying.

    “So I slowly worked on the tract with my fingertips, enlarging it and extending it with my arm inside the wound up to above my elbow. I had to keep stopping because it was cutting off the blood supply to my arm, but I also had to work as fast as I could. I was having to push and pull so much that I was physically moving the horse around on the table.

    “Finally, I felt something at the tip of my finger and as I wrapped my fingers around it, I could feel it move. I tried to ensure I had it all in my hand because not only was I worried that I might not get it all out, but that he might come round and not be able to move his left leg.

    “All of a sudden, the object started to come out easily — and there it was, a 4x2in splinter of fence post. Having checked there was nothing left behind, I thoroughly lavaged the wound and stitched it with a large drain in place.

    “Thankfully, the horse came through the recovery safely from the general anaesthetic, and the wound healed up surprisingly well.”

    Read more remarkable veterinary stories in this week’s issue of Horse & Hound magazine (14 May 2015)

    Please note, the picture above is not of this particular veterinary case

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